Fringe Vascular Framework

Presentation Transcript

Peripheral Vascular System • Consists of a system of intertwining veins and arteries which carry blood to and from the heart and lungs • Also involves the capillaries and lymph system

Peripheral Vascular Disease • Disorders which alter the normal flow of blood through the arteries and veins • Effects the lower extremities more frequently the the upper • A client with a diagnosis of PVD implies arterial disease rather than venous • Some client have both arterial and venous disease

Patho • PVD is the manifestation of systemic atherosclerosis • Chronic condition in which partial or total occlusion deprives the lower extremities of oxygen and nutrients • Fatty substances accumulate at the site of vessel wall injury and alter or occlude the blood flow • Risk factors: • Hypertension, smoking, high lipids and cholesterol, diabetes, obesity and family predisposition

Arterial Embolism, cont. • Immediate treatment to prevent permanent damage or loss of extremity • 1st intervention is Heparin • May need embolectomy • Can be done with arthroscopy • May need to open and remove embolus • Post-op care involves watching for color changes and signs of occlusion • May have spasms and swelling • Also may develop compartment syndrome

Raynaud’s Disease • Caused by vasospasms of the arterioles and arteries of the upper and lower extremities • Affects hands but can be on toes and tip of nose • S/S – chronic, intermittent, numbness, coldness, pain and pallor • Women 16-40 years of age • Cause is unknown • After spasm the skin becomes reddened and hyperemic

Buerger’s Disease(Thromboangiitis Obliterans) • Uncommon occlusive disease of the medium and small arteries and veins • The distal upper and lower limbs are most frequently affected • In young adult men who smoke • May result in fibrosis and scarring of the perivascular system

Buerger’s Disease(Thromboangiitis Obliterans) • Pain in the arch of the foot is the first clinical indicator • Pain may be ischemic in nature • Clients have increased sensation to cold • Pulses may be diminished in the distal extremities and are cool and red or cyanotic • Ulcerations and gangrene may occur • Treatment is same as with Raynaud’s

Aneurysms • Permanent localized dilation of an artery • Area stretches and weakens, and balloons out • As it enlarges the risk of rupture increases • Can be acquired or congenital • Acquired are caused by trauma, arteriosclerosis, or infection • Abdominal aorta is most prevalent site –(AAA are about 75%)

Aneurysms, cont. • S/S • Most are asymptomatic • May be discovered on routine exam • Pain may be caused by the pressure on organs surrounding the aneurysm • May notice a pulsation in the upper abdomine or by hearing a bruit

Aortic Dissection, cont. • Symptom • Pain which is a tearing, ripping, stabbing that tends to move from the point of origin • Pain may be in the anterior chest, back, neck, throat, jaw or teeth • Emergency care • Elimination of pain • Control B/P – 100 to 120 systolic or lower • If uncomplicated may be conservative treatment • If dissection is in the proximal aorta, require CPB

Aortic Dissection • Not a rupturing aneurysm • Dissecting hematoma or aortic dissection • Caused by a sudden tear in the aortic intima • Hypertension is a contributing factor • Relatively common - 2000/year in the US • Ascending aorta and the descending thoracic aorta are the most common sites